Newsletter

The Agency for Health Care Administration has blasted an administrative law judge’s recommendation that a company partly owned by Jacksonville-based Florida Blue is not eligible for a Medicaid contract worth an estimated $2.3 billion in its first year alone.

Because the agency, and not the judge, has the final say, the agency’s objection filed Thursday in administrative court likely means the company will secure the new business after all.

The company, Prestige Health Choice, won the ability to serve Medicaid patients in Monroe and Miami-Dade Counties as part of the state’s transition to a managed-care system.

Under that plan, private insurers – not the government – serve Medicaid patients across the state. Those companies compete for contracts to serve patients in 11 regions.

A separate company, Florida True Health, owns a 40 percent stake in Prestige with an option to purchase the additional 60 percent. Florida True Health was formed in by Florida Blue and Philadelphia-based AmeriHealth Caritas.

After being purchased by Florida True Health, Prestige was awarded contracts in eight of the state’s 11 regions.

One of those awards – the South Florida contract – was challenged by Hallandale-based Care Access.

The company alleges, in part, that Prestige’s corporate structure makes it ineligible to have the contracts it was awarded. The company won those contracts as a so-called “Provider Service Network,” a type of health care provider that must be majority-owned by health-care providers.